血清β-HCG和孕酮联合检测在异位妊娠早期诊断中的意义

摘要

目的 探讨血清β-HCG和孕酮联合检测在异位妊娠早期诊断中的意义.方法 选取收治入院的28例异位妊娠患者为异位妊娠组,同期30例正常妊娠的妇女为正常早孕组,比较2组对象血清中孕酮值和β-HCG 48h增长率,分别计算单独检测β-HCG 48h增长率、血清孕酮以及联合检测血清β-HCG 48h增长率和孕酮诊断异位妊娠的敏感度、特异度、诊断符合率.结果 异位妊娠组和正常早孕组孕酮水平[(29.3±2.2)nmol/L vs (132.3±3.5)nmol/L]和β-HCG 48 h增长率[(24.2±3.5)%vs(132.4±5.6)%]比较差异具有统计学意义(P<0.01),单用β-HCG诊断异位妊娠的诊断符合率为77.6%,单用孕酮的诊断符合率为70.7%,而联合β-HCG和孕酮诊断异位妊娠的诊断符合率可达91.4%,联合检测诊断符合率优于单项指标监测,差异有统计学意义(P＜0.05).结论 联合检测血清β-HCG和孕酮对异位妊娠的早期诊断具有较高的实用价值.%Objective To investigate the value of detection serum level of β-HCG combined with progesterone for early diagnosis of ectopic pregnancy. Methods 28 patients suffered from ectopic pregnancy and 30 women with normal intrau-terine gestation were enrolled in the study. The serum level of progesterone and β-HCG were detected at visiting day ( Oh ), and the serum level of β-HCG was detected again at the time of 48 h later, and β-HCG 48h increasing rate was calculated. The serum level of progesterone and β-HCG 48h increasing rate were compared between two groups. The susceptibility, specificity, and diagnose accordance rate of three methods including detection serum level of progesterone, β-HCG 48h increasing rate and combined detection for diagnosis ectopic pregnancy were calculated. Results There were significant differences between ectopic pregnancy group and normal intrauterine gestation group in the serum level of progesterone [ ( 29. 3 ± 2. 2 )nmol/ L vs. ( 132. 3 ± 3. 5 )nmol/L ], there are also significant differences between ectopic pregnancy group and normal intrauterine gestation group in β-HCG 48h increasing rate [ ( 24. 2 ± 3. 5 )% vs. ( 132. 4 ± 5. 6 )% ]. The diagnose accordance rate of ectopic pregnancy by the method of β-HCG 48h increasing rate was 77. 6% , by the method of detection of serum level of progesterone was 70. 7% , by the method of combined detection of serum level of progesterone with β-HCG 48h increasing rate was 91.4% , the differences among these three methods is significant, the diagnose accordance rate of ectopic pregnancy by the method of combined detection of serum level of progesterone with β-HCG 48h increasing rate was far higher than the other two methods ( P <0.05 ). Conclusion The method of combined detection serum level of progesterone with β-HCG 48h increa sing rate would be very valuable for diagnosis of early ectopic pregnancy.